hello everyone and welcome back to the 13th episode of the Diary of an endodontist and today we have a very interesting case of trauma so stay with [Music] me this patient was referred to us and he had a trauma of the upper right one so he fractured the crown as you can see here part of the crown is missing on the upper right one all the other teeth seem to be fine apart from the gingera is slightly inflamed on the P aspects there's still a small fragment inside of the gingera and there is pop exposure
the patient was in pain and we also noticed the ulceration on the lower in this area of the fenom where he said that the the piece of the truth probably went through that and came out of the mouth during the accident he couldn't remember that well but they couldn't find any piece of the truth the X-ray there is no coron there is a coronal fracture but there is no root fracture and the margin as you can see is pretty much what we saw in the mouth and the bone level is in a good position the
gingera so the truth is is restorable as we know the Plato piece was removed moved and the tooth isolated for the root canal treatment as you can see I used a small prolar clamp but you you can use the anterior clamp there is no no right or wrong whatever you feel comfortable the reason why I like to use the more prolar clamps for the anterior is that I put on the other side where my nurse doesn't have this part of the clamp in her view and she can put the suction and is a lot easier
iier for us to work but it doesn't matter as long as you isolate so you don't have any sodium hypochlorite going under your rubber Dum then I'll be happy which whichever clamp you find easier for you the root canal treatment was performed and then we went on a discussion based on the previous picture with the patient um I had that discussion previously and of course wanted to know what to do with this truth I didn't want the patient to go back home with that P missing uh I love Composites um I love the restorative side
of it so I offer to the patient that composite feeling would be enough in this case I don't think we need any post at all there is enough tooth for you to bond composite I fractured my tooth when I was nine and I and I have just a composite feeling and it's being there for forever I never had any chip of that tooth so it's absolutely fine for me and aesthetically is wonderful you don't need to match to uh the porcelain to a natural color you can just match the the composite which in my opinion
I feel a lot easier in my hands to do that while the patient is is with me during the root canal treatment so the composite was performed on that visit of course the gingera is still a bit swollen a bit inflamed but it it will heal it's just a matter of time just that the the accident happened just few weeks ago and um as long as you bone the composite properly following all the your your protocol good protocol of etching bonding and composite and make sure the occlusion is fine as well make all the Jo
excursions protrusion lateral excursions and make sure there is no huge contact interference for that composite to fracture in future if you follow all that protocol then that composite should last for a long time of course let the patient know that if the composite starts to cheap uh then you can think about a plan B perhaps a veneer or a crown but for the time being I think it's pretty aesthetic the patient is young so it's good to have that back into to function without any problem and as you can see the two views if you
follow I like to follow the same vertical inclination as well for the aesthetic is a lot better and yeah I think that that would be the only thing is the the occlusion and also let the patient know not to buy on any apple or any french bread or anything that you could do that movement because that can force the composite to fracture so I hope you have enjoyed this case and I hope you you end up doing more Composites instead of sacrificing all the the truthy structure to a crown for example thank you very much
for staying with us and if you if you want to contact us you can leave the comments below or you can find me on Instagram or LinkedIn or even on the website you take [Music] care
